Annals of vascular surgery
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In this study, 18 patients (17 men and 1 woman; mean age 61 years) with a previously infected vascular graft underwent vascular reconstruction with cryopreserved arterial allografts. Treatment consisted of first total (n = 11) or partial removal (n = 7) of infected prosthetic grafts. Revascularizations were aortoaortic (n = 2), aortobifemoral (n = 8), aortounifemoral (n = 3), femorofemoral (n = 2), iliofemoral (n = 1), or femoropopliteal (n = 2) bypasses. ⋯ One patient had a hemorrhage due to femoral allograft rupture at 45 days, and two patients had aortic allografts dilatation with mural thrombus, necessitating a prosthetic replacement in one patient. Cryopreserved allografts used for the treatment of infected vascular graft are useful in selected cases, although they are not totally resistant to infection. Patients should be followed closely to detect significant long-term alterations of the allografts.
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Review Case Reports
Recurrent embolism caused by floating thrombus in the thoracic aorta.
A case of embolic recurrent episodes resulting in acute lower-limb ischemia from an unusual source is reported. This occurred in a patient on steroids for rheumatoid arthritis. Femoropopliteal thromboembolectomy successfully restored arterial flow. ⋯ The thrombus was identified by transesophageal echocardiography and was successfully removed by aortic thromboendarterectomy. We emphasize the importance of transesophageal echocardiography as a reliable method for the diagnosis of thoracic aorta diseases and for identification of aortic thrombi. An aggressive surgical approach is recommended in the low-risk patient to prevent further embolic episodes.